Transfusion related acute lung injury

• Main Authors: Sharma Ratti, Bhattacharya Prasun, Thakral Beenu, Saluja Karan, Marwaha Neelam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2009-10-01
• Series: Indian Journal of Pathology and Microbiology
• Subjects: Blood components; lung injury; transfusion
• Online Access: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2009;volume=52;issue=4;spage=561;epage=563;aulast=Sharma

Transfusion related acute lung injury (TRALI) is an uncommon but potentially fatal adverse reaction to transfusion of plasma containing blood components. We describe a case of 10-year-old male child with aplastic anemia, platelet count of 7800/΅l, B positive blood group who developed fever (39.2΀C), difficulty in breathing and cyanosis within 2 hrs after transfusion of a random platelet concentrate. Despite the best resuscitative efforts, the child died within next 24 hrs. The present case highlights the fact that TRALI should be kept as a differential diagnosis in all patients developing acute respiratory discomfort within 6 hrs of transfusion. Without a ′gold standard′ the diagnosis of TRALI relies on a high index of suspicion and on excluding other types of transfusion reactions. Notification to transfusion services is crucial to ensure that a proper investigation is carried out and at-risk donor and recipients can be identified, and risk reduction measures can be adopted.